Department of Otorhinolaryngology, Kocaeli City Hospital, Kocaeli, Turkey.
Department of Otorhinolaryngology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
Niger J Clin Pract. 2024 Jul 1;27(7):859-864. doi: 10.4103/njcp.njcp_38_24. Epub 2024 Jul 27.
Detection of nodal metastasis is critical for the treatment and prognosis of head and neck cancer (HNC). Positron emission tomography/computed tomography (PET/CT) is increasingly being used to detect cervical lymph node involvement.
The purposes of this study were to (1) investigate the diagnostic accuracy of PET/CT for the detection of neck metastasis in patients with HNC and (2) determine the effect of the time interval between surgery and PET/CT.
Fifty patients with head and neck squamous cell carcinoma who underwent PET/CT before surgery were included in this study. Preoperative PET/CT images that determined lymph node metastasis were compared with the histopathological analysis of neck dissection samples. Neck dissections were divided into three groups according to the time interval between surgery and PET/CT (0-2 weeks, >2-4 weeks, and >4 weeks). The concordance between PET/CT and histopathology was measured using the neck sides at different time intervals. The specificity, sensitivity, accuracy, negative predictive value (NPV), and positive predictive value (PPV) of PET/CT in detecting metastatic lymph nodes in the neck were calculated.
A total of 79 neck dissections were included in the study as 29 (58%) of the patients underwent bilateral neck dissection. The overall accuracy of PET/CT in detecting nodal metastasis was highest for the 0-2 weeks interval (95.6%). During this time interval, the sensitivity, specificity, NPV, and PPV of PET/CT were 100%, 90.9%, 100%, and 92.3%, respectively.
Although PET/CT is an important and reliable diagnostic method for detecting nodal metastases in patients with HNC, its reliability decreases as the time between surgeries increases. The optimal interval was 2 weeks; however, up to 4 weeks was acceptable.
检测淋巴结转移对于头颈部癌症（HNC）的治疗和预后至关重要。正电子发射断层扫描/计算机断层扫描（PET/CT）越来越多地用于检测颈部淋巴结受累情况。
本研究旨在（1）研究 PET/CT 对头颈部鳞状细胞癌患者颈部转移检测的诊断准确性，（2）确定手术与 PET/CT 之间时间间隔的影响。
本研究纳入了 50 例接受手术前 PET/CT 的头颈部鳞状细胞癌患者。将术前 PET/CT 图像确定的淋巴结转移与颈清扫标本的组织病理学分析进行比较。根据手术与 PET/CT 之间的时间间隔（0-2 周、>2-4 周和>4 周），将颈清扫术分为三组。使用不同时间间隔的颈部侧位来测量 PET/CT 与组织病理学之间的一致性。计算 PET/CT 在检测颈部转移性淋巴结方面的特异性、敏感性、准确性、阴性预测值（NPV）和阳性预测值（PPV）。
本研究共纳入 79 例颈清扫术，其中 29 例（58%）患者接受了双侧颈清扫术。PET/CT 在检测淋巴结转移方面的总体准确性在 0-2 周间隔时最高（95.6%）。在这个时间间隔内，PET/CT 的敏感性、特异性、NPV 和 PPV 分别为 100%、90.9%、100%和 92.3%。
尽管 PET/CT 是一种重要且可靠的诊断方法，可用于检测 HNC 患者的淋巴结转移，但随着手术间隔时间的增加，其可靠性会降低。最佳间隔时间为 2 周，但最长 4 周也是可以接受的。
